About Your Ketamine Infusion Treatment

This information explains what to expect during your ketamine infusion treatment at MSK.

About ketamine infusion therapy

Ketamine is a medicine used to help you manage neuropathic pain (nerve pain) during and after your cancer treatment. Ketamine infusion slows down your pain-sensing nerves that send pain messages to your brain. This may lower your pain level and make you feel relaxed. The infusion may bring you pain relief over the next few days and weeks.

Your doctor may recommend you have ketamine infusion therapy if you:

• Experience side effects from other pain medicine.
• Do not get enough relief from other pain medicine.
• Experience pain that is hard to control.

Ketamine infusion therapy works quickly. You may start feeling better right away.

Each treatment session lasts 4 to 6 hours. You may want to bring a book or music to help pass the time during your session.

Most people get long-term pain relief (pain relief lasting at least 1 month) after 2 or 3 sessions. Once this pain relief happens, you may continue receiving therapy. Most people receive treatment once a month. Your doctor will discuss with you how often you should receive treatment.

1 week before your treatment

Arrange for someone to drive you to and from your appointment

After your treatment, you may feel drowsy and will not be able to drive. You must have a responsible care partner take you home. If you do not have a responsible care partner to take you home, your treatment will be canceled.

A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your treatment.

If you do not have a responsible care partner to take you home, call one of the agencies below. They will send someone to go home with you. There is a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.

The day of your treatment

Follow a clear liquid diet

You will need to follow a clear liquid diet the day of your treatment. A clear liquid diet includes only liquids you can see through. Examples are listed in the “Clear Liquid Diet” table.

While you are following this diet:

• Do not eat any solid foods.
• Try to drink at least 1 (8-ounce) cup of clear liquid every hour while you are awake.
• Drink different types of clear liquids. Do not just drink water, coffee, and tea.
• Do not drink sugar-free liquids unless you have diabetes and a member of your care team tells you to.

For people with diabetes

If you have diabetes, ask the healthcare provider who manages your diabetes what you should do while you are following a clear liquid diet.

• If you take insulin or another medicine for diabetes, ask your healthcare provider if you need to change the dose.
• Ask if you should drink sugar-free clear liquids.
• If you have an insulin pump, you will need to get clearance from the healthcare provider that manages your diabetes care before stating ketamine infusion treatment. Clearance is when your healthcare provider says you can safely get the treatment.

While you are following a clear liquid diet, make sure to check your blood sugar level often. If you have any questions, talk with your healthcare provider.

Things to remember

• Wear something comfortable and loose-fitting.
• Take your pain medicine and other medicine as you normally do.
  • If you take your medicine during the 2 hours before your treatment, take your medicine with small sips of water.
• You must arrive on time. Your treatment may need to be rescheduled if you arrive late.
• If you are going to be late, call after 6 a.m. to tell your care team. Leave a message with the charge nurse or unit assistant.
  • If your treatment will be at the Josie Roberson Surgery Center, call 646-888-7046.
  • If your treatment will be at MSK Monmouth, call 848-225-6090.
• You will need to give your nurse the name and phone number of the person or agency service that will be taking you home after your treatment. If you do not have this information, your treatment will be canceled.

Visitor policy

Visit www.msk.org/visit for the most up-to-date information about our visitor policy.

Where to go

Remember, you will not be able to drive for the rest of the day after your treatment. You must have someone drive you to and from your appointment.

Your ketamine infusion treatment appointment will be at one of the MSK sites below. Visit www.msk.org/parking for parking information and directions to all MSK locations.

Josie Robertson Surgery Center

1133 York Ave. (between East 61^st and East 62^nd streets)
New York, NY 10065

Memorial Sloan Kettering Monmouth

480 Red Hill Rd.
Middletown, NJ 07748

There is a valet service at the MSK Monmouth entrance. The service is free.

What to expect

When you arrive for your appointment, a staff member will direct you to the check-in area. A staff member can walk with you or bring you there in a wheelchair, if needed.

Check in at the reception desk, then have a seat in the waiting area. A staff member will meet you and bring you to the treatment suite.

Your nurse will ask you for the name and phone number of the person who will be taking you home after your treatment. If you do not have someone to take you home, your treatment will be canceled.

During your treatment

Your nurse will talk with you about your treatment and answer your questions. They will also ask you questions about your pain level. Your nurse will use your responses to adjust the medicine for your treatment. You can learn more about describing your pain by watching our video How to Describe Your Cancer Pain.

During your treatment, you will lie on a bed with a pillow and blanket. Your nurse will help you get comfortable and will place an intravenous (IV) line into your arm. The IV line will be connected to a machine that will give you low doses of ketamine. This should make you feel relaxed.

Your nurse will keep track of your temperature, pulse, blood pressure, and oxygen levels during your whole treatment. They may not be in your room the whole time. If you need anything while your nurse is out of the room, you can use the call bell to reach them.

Your treatment will take 4 to 6 hours.

You may feel nauseous (like you are going to throw up) and drowsy at the start of your treatment. If you feel uncomfortable at any point, tell your nurse. They will adjust your treatment to help you feel better.

When your session is finished, you will stay in the treatment suite for about 1 hour to recover from your treatment.

After your treatment

• Your nurse will go over any discharge instructions you have to follow after your treatment.
• You will feel drowsy right after your treatment. You should spend the rest of your day resting.
• You may have other side effects. Your doctor will give you more information.
• Do not sign any important documents or make any important decisions for 24 hours after your treatment. You may feel drowsy and not fully alert.
• Do not drive for the rest of the day after your treatment.
• You can follow your normal diet after your treatment.
• You can go back to doing your usual activities the day after your treatment.
• Continue taking your pain medicine, unless your care team tells you to stop.

When to call your healthcare provider

Call your healthcare provider if you:

• Feel nauseous.
• Vomit (throw up).
• Feel dizzy.
• Feel confused.
• Have any questions or concerns.

Contact information

If you have any of these side effects after your treatment, call the Anesthesia Pain Service at 212-639-6851. You can reach us Monday through Friday from 9 a.m. to 4 p.m. If it’s after 4 p.m., during the weekend, or on a holiday, call 212-639-2000. Ask for the anesthesia pain person on call.